The present invention is directed to apparatus for controlling and monitoring of the dispensing of oral medications, specifically medications in the form of pills or containers of medication in powder or liquid form. The apparatus reminds the patient that medication has to be taken, provides information about the drug and further provides a monitoring function for physicians, pharmacies or other interested parties with respect to the compliance by the patient in the taking of the medication. The apparatus also has the capability of receiving data from portable monitoring devices e.g. electrocardiogram or blood pressure devices, and transferring that data e.g. to health care centres.
The common procedure with respect to medications is for the physician to issue a prescription, which is subsequently filled by a pharmacy. The patient is then required to take the medication in the manner that has been prescribed by the physician. The patient may be taking the medication in their own residence, but in other circumstances they may be residing in a multiple residence or in an institution. In some circumstances, the patient will have a family member or a friend to assist and/or remind them in the taking of the medication. In other instances, the patient may not be willing to involve such a person or may live alone or merely wish to be solely responsible for the taking of the medication at the prescribed times.
It is believed that more than 50% of persons prescribed medications (drugs) for medical reasons do not take those medications as directed. While such non-compliance can be due to unacceptable side-effects or to lack of trust in the prescription or the prescriber, more commonly failure to take medication is due to simple forgetfulness or to inadequate knowledge of how and why the medication is to be taken. It is also well known that the rate of compliance declines as the number of medications and the number of times medications must be taken each day increases. Thus the sickest, who need the medications the most, are the least likely to take them correctly. Among the elderly, who are the largest consumers of medication and medical services, these problems are compounded by memory impairment, difficulties with vision, tremor and poor manual dexterity, such that labels cannot be read, vials opened or small tablets removed. Missed doses or inadvertant overdoses, even to the point of toxicity, are common.
Frequently physicians do not recognize that compliance is poor, and mistakenly attribute failure to improve to inadequacy of drug dose, wrong drug type or incorrect diagnosis. The physician may then erroneously increase the dose, add a supplementary drug, switch to a new (and often more toxic or expensive) medication, order additional medical tests or even hospitalize the patient. The costs of these unnecessary procedures and treatments run into billions of dollars per year, and much avoidable suffering is endured by the sick.
Electronic devices have been developed that may be programmed and which will beep or flash at appropriate times. Containers with microelectronic recording devices to record the opening of the container are also known. Alternatively, packaging methods may be used to assist in the taking of the medication, especially when a particular sequence of medications is required, for example in birth control where the type of medication is varied over the month.
An apparatus has now been found that is capable of both controlling the dispensing of the medication and monitoring the dispensing of the medication by a number of persons, and of providing drug information.
Accordingly, the present invention provides a medication dispensing cassette comprising:
a) a housing;
b) at least one continuous track having a plurality of receptacles for medication, each receptacle accommodating one dosage of said medication, said track being within said housing;
c) a drive mechanism for said continuous track; and optionally
d) a data storage system capable of storing data on a least one of name of patient, medication being dispensed, expiry date of medication, time for dispensing of medication, medication dosage and information pertaining to use of medication.
In a preferred embodiment of the cassette of the invention, the medication is in the form of a pill, a powder or a liquid, the powder or liquid preferably being in a container, the receptacles being of a size to accommodate such medication.
In another embodiment, at least some receptacles have more than one medication, all of which are to be dispensed at the same time.
The present invention further provides a medication dispensing apparatus, comprising:
a) a medication dispensing cassette having a housing, at least one continuous track having a plurality of receptacles for said medication, each receptacle accommodating one dosage of said medication, said continuous track being within said housing, a drive mechanism for said continuous track, and optionally a data storage system capable of storing data on a least one of name of patient, medication being dispensed, expiry date of medication, time for dispensing of medication, medication dosage and information pertaining to use of medication;
b) a holder for said cassette, said holder having a microprocessor to monitor and effect movement of said continuous track in said cassette using said drive mechanism, said microprocessor further monitoring said release and controlling release of said medication according to a predetermined schedule including to a programme in the microprocessor or down-loaded from the data storage system of the cassette; and
c) an electrical supply for said microprocessor.
In a preferred embodiment of the medication dispensing apparatus of the invention, the holder further comprises a communication system for transmission of data relating to release of medication to a remote location.
In another embodiment, the microprocessor retains and provides for display of drug information.
In a further embodiment, the controller is adapted to receive data from a peripheral device e.g. an electrocardiograph or blood pressure monitor, and distribute said data to a remote location, the holder having communication means to communicate data from the controller to the remote location and to receive data from the remote location.
In yet another embodiment, the controller is re-programmable with data received from the remote location.
In addition, the present invention provides a system for dispensing oral medication to a patient, said system comprising:
a) a dispenser for said medication;
b) a controller for said dispenser, said controller monitoring dispensing of medication from said dispenser and comparing said dispensing of medication with a predetermined schedule for dispensing of said medication;
c) a data management system interconnected with said controller, said data management system receiving input from said controller on compliance with removal of the medication from said dispenser according to said predetermined schedule, said data management system further communicating information on dispensing of said medication to a remote location.
In a preferred embodiment of the system, the data management system is remote from said controller, especially a centralized data management system interconnected with a plurality of controllers.
In further embodiments, the remote location to which the data management system communicates information on dispensing of said medication is at least one of a physician""s office, a pharmacy, a hospital, an insurance company, a senior""s residence monitoring office or an individual, especially an individual who is a friend of or related to said patient.
In another embodiment, the medication is in the form of a pill, a powder or a liquid, the powder or liquid preferably being in a container.
In yet another embodiment, at least some receptacles have more than one medication, all of which are to be dispensed at the same time.